International Braz J Urol最新文献

{"title":"Enhancing Robotic Surgery Training and Reducing Remote Complications with Telesurgery Technology.","authors":"Marcio Covas Moschovas, Shady Saikali, Travis Rogers, Mischa Dohler, Michael Mcdonald, Ela Patel, Jeffrey Marquinez, Ahmed Gamal, Jeffery Magnuson, Vipul Patel","doi":"10.1590/S1677-5538.IBJU.2025.0082","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0082","url":null,"abstract":"<p><strong>Introduction: </strong>The 2001 Lindbergh operation provided evidence for the feasibility of transatlantic telesurgery.(1-3) However, technological and economic challenges have limited the implementation of this technique.(4-6) This video illustrates details of a telesurgery connection over a 13,000 km distance between Orlando (USA) and Shanghai (China). Surgeons at both locations operated simultaneously on the same animals using telesurgery consoles (MicroPort® MedBot™) for teleproctoring, allowing for a robust evaluation of connectivity and robotic system performance across vast distances.</p><p><strong>Methods: </strong>On July 23rd and 24th, 2024, we conducted a prospective telesurgery study using live animal models (porcine) connecting Orlando to Shanghai. We reproduced a real-life telesurgery scenario where both ends of the connection had control over the robot. Four surgeons were in Orlando and one in Shanghai. We illustrated the communication between surgeons and highlighted the potential of telesurgery to improve outcomes and teaching robotic surgery.</p><p><strong>Results: </strong>Connectivity and robotic technology performed optimally for several hours without troubleshooting or malfunctions. Median delay was 139 milliseconds (137-216) on the first day and 139 milliseconds (137-185) on the second day. The surgeons were able to switch the console control multiple times during the procedures. They could communicate, discuss cases in real-time, and seamlessly transfer control in critical steps of the surgery.</p><p><strong>Conclusions: </strong>This video underscores the practical potential of Telesurgery use in teleproctoring, particularly when an experienced remote surgeon steps in to assist another surgeon during complex or challenging procedures. It highlights Telesurgery's potential for training and improving outcomes in robotic surgery.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Step to Equity and Organization in Waiting Lines for Stone Surgery. Translation of Prioritization Scores.","authors":"Guilherme Gentile, Fabio Carvalho Vicentini, Erik Montagna, Daniel Pérez-Fentes, Guilherme Pimenta Roncete, Artur Henrique Brito, Fabio Miranda Torricelli, Alexandre Danilovic, Carlos Alfredo Batagello, Eduardo Mazzucchi, William Carlos Nahas","doi":"10.1590/S1677-5538.IBJU.2025.0039","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0039","url":null,"abstract":"<p><strong>Purpose: </strong>The use of patient prioritization tools is one of several methods to enhance the management of waiting times for elective surgeries. Developing these tools specifically for urinary stones in the Brazilian context may enhance queue management and increase patient satisfaction. This study aims to adapt two previously published scores, the WCWL (Western Canada Waiting List - general criteria) and the SCQ-score (specific to urinary stone criteria), into Brazilian Portuguese.</p><p><strong>Materials and methods: </strong>Our study adhered to established protocols for the cross-cultural adaptation and translation of health-related questionnaires. The process for translating both original scores involved four steps: initial translation, back-translation, committee review, and pre-testing. The translations were conducted by professionals proficient in the relevant languages. The pre-test phase engaged eight endourologists who applied the translated versions of the scores to twelve hypothetical patient cases.</p><p><strong>Results: </strong>Our study successfully produced Brazilian Portuguese versions of the SCQ and WCWL scores. During the pre-testing, these scores were found to be quick to perform (with an average completion time of 1 minute and 35 seconds) and were deemed easy to understand and use by the endourologists. However, there was a concern regarding the practical utility and interpretability of the WCWL score due to its more generalized criteria.</p><p><strong>Conclusion: </strong>We successfully developed the Brazilian Portuguese version of the Western Canada Waiting List and SCQ-score. This development will allow further studies to evaluate the impact of their use within the Brazilian healthcare environment.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Alpha Lipoic Acid Supplementation in Sperm Parameters: A Systematic Review and Meta-Analysis of Randomized Trials.","authors":"Iago Zang Pires, Marília Oberto da Silva Gobbo, Renan Yuji Ura Sudo, Tanize Louize Milbradt, Nilson Marquardt, Gustavo Franco Carvalhal, Carlos Teodosio Da Ros","doi":"10.1590/S1677-5538.IBJU.2024.0614","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0614","url":null,"abstract":"<p><strong>Introduction: </strong>Male factors contribute to 30 to 50% of infertility in couples. Treatment options for male infertility are limited, so antioxidant supplementation for idiopathic male infertility is currently being studied. Alpha lipoic acid (ALA) has a high antioxidant capacity and the potential to penetrate tissues, cells, and organelles, including mitochondria, due to its water and lipid solubility properties. The recent inclusion of randomized trials in the literature has required a new systematic review and meta-analysis to evaluate the efficacy of alpha lipoic acid in sperm parameter changes.</p><p><strong>Purpose: </strong>We aimed to perform a systematic review and meta-analysis of the currently available randomized trials comparing the effects of ALA supplementation versus placebo on sperm function in infertile male patients.</p><p><strong>Material and methods: </strong>Pubmed, Embase, Cochrane Library, and Scopus databases were searched from inception to June 2024. A random-effects model was employed to compute mean differences and risk ratios for continuous and binary endpoints. Heterogeneity was evaluated through the prediction interval. A sensitivity analysis was conducted by systematically excluding one study at a time and recalculating the pooled effect. All statistical analysis was conducted using R software 4.4.1. The certainty of evidence was evaluated with the GRADE approach. Results were reported following the PRISMA statement guidelines. This study was registered in PROSPERO.</p><p><strong>Results: </strong>Five randomized trials comprising 250 patients with a mean age of 28 to 40 years were included in this analysis. Over a mean follow-up time of 3 months, ALA was associated with a reduced proportion of abnormal sperm morphology (MD -0.89; 95% CI -1.48 to -0.29; p=0.003), increased total motility (MD 13.49; 95% CI 3.52 to 23.46; p=0.008), and increased sperm progressive motility (MD 12.43; 95% CI 2.89 to 21.97; p=0.01). Additionally, ALA was associated with a higher pregnancy rate in two individual studies reporting the outcome, however, no significance was found in our pooled analysis (RR 2.28; 95% CI 0.66 to 7.85; p=0.1). Finally, ALA did not change ejaculation volume (MD 0.14; 95% CI -0.54 to 0.83; p=0.6), sperm concentration (MD 11.99; 95% CI -0.67 to 24.66; p=0.06), live sperm (MD 4.42; 95% CI -3.17 to 12.02; p=0.2), or total antioxidant capacity (MD 0.43; 95% CI -0.02 to 0.87; p=0.06). No adverse events were reported.</p><p><strong>Conclusion: </strong>In this meta-analysis, ALA was associated with a favorable change in sperm quality. However, there were no effects on pregnancy rates. ALA should be considered for patients with idiopathic infertility.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes and Cost-effectiveness between the Sentire® and da Vinci® systems in Robot-assisted Radical Prostatectomy.","authors":"Run-da Jiao, Zheng Wang, Xian-Gui Kong, Shou-Yan Tang, Dan Xia, Zhen-Jie Wu, Jian-Chao Liu, Li-Hua Liu","doi":"10.1590/S1677-5538.IBJU.2024.0706","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0706","url":null,"abstract":"<p><strong>Objective: </strong>Robotic surgery has enhanced minimally invasive procedures with greater precision and control, but high costs have limited its widespread adoption. The Sentire® surgical system is hypothesized to achieve clinical outcomes comparable to those of the da Vinci® system while demonstrating superior cost-effectiveness in robot-assisted radical prostatectomy (RARP) procedures. This study aimed to compare RARP outcomes using Sentire® and da Vinci® ®, focusing on clinical efficacy and economic impact.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted at three high-volume urology centers in China, including 22 patients who underwent RARP with the Sentire® system and 287 patients who underwent RARP with the da Vinci® system. After 1:3 propensity score matching (PSM), 66 patients were successfully matched in the control group. Perioperative outcomes and cost metrics were assessed. Key measures included operative and console times, docking time, blood loss, recovery, positive surgical margins, surgeon evaluations of performance and comfort, and cost-effectiveness.</p><p><strong>Results: </strong>The Sentire® group had a longer median operative time (143 vs. 112 minutes, p=0.024), while console time (85 vs. 76 minutes, p=0.323) and docking time (9.0 vs. 6.0 minutes, p=0.279) were comparable. Blood loss was also similar between the groups (p=0.093). Positive surgical margin rates were 22.7% for Sentire® and 20.0% for da Vinci® (p=1.000), and no significant differences were observed in pathological ISUP grades or prostate volumes (p=0.327 and p=0.856, respectively). At 1-year follow-up, PSA recurrence was observed in 3 patients in the Sentire® group (4.5%) and 4 in the control group (6.1%) (p=0.625), with similar median PSA levels (0.012 vs. 0.014 ng/mL, p=0.410). Urinary continence rates were also comparable at 1, 3, and 12 months (all p > 0.05). Cost-effectiveness analysis revealed lower total and direct costs in the Sentire® group, including surgery expenses ($8,750 vs. $10,500, p=0.021), although differences in consumable and indirect costs were not statistically significant. Surgeon satisfaction scores for performance and comfort were slightly better for Sentire® but did not reach statistical significance (p > 0.05).</p><p><strong>Conclusion: </strong>This study demonstrates that the Sentire® system is well-suited for urological surgeries, offering comparable clinical outcomes and shorter hospital stays while improving cost-effectiveness compared to the da Vinci® system.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic Ureteropelvic Junction Disruption from Lumbar Spinal Fusion Surgery: Early Repair using The SP Robotic System.","authors":"Arianna Biasatti, Leslie C Licari, Eugenio Bologna, Angelo Orsini, Matthew C Pearson, Riccardo Autorino","doi":"10.1590/S1677-5538.IBJU.2024.0690","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0690","url":null,"abstract":"<p><strong>Introduction: </strong>Severe iatrogenic ureteral injuries are uncommon but challenging clinical scenarios, mostly related to abdominal and gynecological surgery (1) but lately also to spinal surgery (2). Prompt management is mandatory to avoid impaired outcomes (3). Moreover, a minimally invasive approach is desirable to minimize surgical morbidity and expedite recovery (4). Single Port robotic surgery is being implemented for a variety of indications, including ureteral surgery (5, 6).</p><p><strong>Materials and methods: </strong>We present the case of a 48-year-old, who underwent lumbar spinal fusion surgery and 3 days after discharge was readmitted presenting abdominal pain. A CT scan revealed a large abdominal fluid collection and consequently a percutaneous drain was placed. A subsequent CT-urogram revealed a right ureteral injury at level of the ureteropelvic junction (UPJ). A percutaneous nephrostomy was inserted after unsuccessful retrograde and anterograde stent placement attempts. The patient underwent SP robotic early repair of the ureter 3 weeks after spinal surgery.</p><p><strong>Results: </strong>SP robotic ureteral injury repair with transperitoneal approach was performed. The surgery was well tolerated without intraoperative complications, patient was discharged on post-operative day 2. Right percutaneous nephrostomy was removed after 2 weeks and ureteral stent after 4. At 6-months follow-up the patient was asymptomatic and CT-urogram confirmed symmetric contrast excretion without hydroureteronephrosis or contrast leakage.</p><p><strong>Conclusion: </strong>SP robotic repair of the UPJ injury is safe and feasible. This procedure provides the benefits of minimally invasive surgery, and it should be considered as a valid alternative to traditional multiport robotic approach.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonically Estimated Bladder and Detrusor Weights in Patients with Post-Void Residual Urine.","authors":"Aderivaldo Cabral Dias, Maria Laura Regis Cabral Dias, Guy Grebot","doi":"10.1590/S1677-5538.IBJU.2025.0126","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0126","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment: Bladder Irrigation with Tap Water to Reduce Antibiotic use for Urinary Tract Infections in Catheter Users.","authors":"Gabriel Zanette Naspolini, Marcio A Averbeck","doi":"10.1590/S1677-5538.IBJU.2025.9912","DOIUrl":"10.1590/S1677-5538.IBJU.2025.9912","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author reply: Is the Effectiveness of Self-Visualization During Flexible Cystoscopy Gender-Dependent in Patients with no Previous Cystoscopy History? A Prospective Randomized Study.","authors":"Nurullah Hamidi","doi":"10.1590/S1677-5538.IBJU.2025.0118","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0118","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Stage Pedicle Preputial Tube Substitution Urethroplasty with Corpora Cavernosa Augmentation Using Buccal Mucosa Graft for Primary Peno-Scrotal Hypospadias Re-pair in Adults.","authors":"Pankaj Joshi, Sanjay Kulkarni, Nicole Albanese, Fausto Negri, Marco Bandini","doi":"10.1590/S1677-5538.IBJU.2024.0650","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0650","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Pre-engagement hypospadias repairs are not uncommon in developed countries like India. Male genital malformations that are not associated with voiding dysfunction are often underreported by families or male patients until the boy reaches marriageable age. At that point, they seek consultation, fearing rejection by potential partners and desiring a rapid and possibly single-stage repair. Therefore, it is not uncommon for primary repair to be performed after puberty, once the penis has fully developed. This may also have consequences on the complexity of surgical repair (1), given that ventral chordee can alter penile development, leading to a higher degree of corporal fibrosis and consequently a more severe ventral curvature. Additionally, the proportion between penile dimensions and craniofacial dimensions is not constant throughout childhood. Genitals are underdeveloped during prepubescence, while the craniofacial region reaches adult dimensions more rapidly, resulting in tissues like buccal mucosa being more abundant compared to adults for pendular urethra reconstruction. These concepts are crucial when planning primary hypospadias repair in adults, as the severity of genital hypospadias may be greater and graft availability may be insufficient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Surgical technique: &lt;/strong&gt;In our practice, it has not been uncommon to encounter cases of primary hypospadias repair where common techniques such as Asopa (2) buccal mucosa graft (BMG) urethoplasty or Bracka two-stage repair were not applicable due to limited availability of BMG to reconstruct the entire penile urethra. In this article, we aim to describe a technique for repairing severe primary hypospadias, where the urethra is reconstructed in a single stage using a pedicle preputial tube, and severe chordee resulting from delayed hypospadias repair combined with corporal fibrosis is resolved through BMG grafting. Patients are typically assessed preoperatively to evaluate the development of the glans for a glansplasty, the availability of the prepuce, and the condition of the buccal mucosa on both cheeks. Subsequently, surgery is performed under general anesthesia with the patient in a supine position. Initially, artificial erection is induced to accurately gauge the severity of curvature. This technique is typically reserved for severe cases of hypospadias where the ventral curvature exceeds 60°. Degloving is then carried out while preserving the vascular support of the prepuce. A circumferential incision is made 5 mm below the coronal sulcus, and both the skin and the dartos are dissected up to the level of Buck's fascia. It is crucial to preserve the vascularization of the dartos during this step, as failure to do so may prevent subsequent flap harvesting. Next, the curvature is reassessed. If a severity above 60° is confirmed, the urethra is transected. However, this step often does not fully resolve the ventral chordee, as the development of the ","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk-adjusted trifecta outcomes in ultrasound-guided RFA of T1a renal masses: experi-ence from a large tertiary cancer center.","authors":"Derun Li, Jiyu Yang, Xiang Wang, Yi Liu, Gangzhi Shan, Zibo Zhang, Xu Han, Zhihua Li, Xuesong Li","doi":"10.1590/S1677-5538.IBJU.2025.0034","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0034","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the trifecta outcomes of ultrasound-guided radiofrequency ablation (RFA) of T1a renal masses and to identify factors influencing trifecta outcomes.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed data from patients who underwent ultrasound-guided RFA at Peking University First Hospital between March 2017 and May 2024. Baseline demographics, perioperative outcomes and follow-up results were collected. The trifecta outcomes were defined as the absence of severe complications, incomplete ablation and tumour recurrence. Multivariate logistic regression analysis was performed to identify risk factors for trifecta failure.</p><p><strong>Results: </strong>Among 270 patients (140 left-sided and 130 right-sided), the median tumour size was 1.97 (range 0.80-3.86) cm, and 32 (11.9%) patients had a history of ipsilateral partial nephrectomy. During the median follow-up of 35.6 (range 6.2-91.4) months, the rates of severe complications, tumour recurrence, and incomplete ablation were 1.1%, 7.4%, and 7.4%, respectively. The trifecta outcome was achieved in 227 (84.1%) patients. Multivariate analysis revealed that tumour size [odds ratio (OR): 2.144, p = 0.007] and history of ipsilateral partial nephrectomy (OR: 3.894, p = 0.002) independently predicted trifecta failure.</p><p><strong>Conclusion: </strong>Ultrasound-guided RFA is a safe and effective treatment for T1a renal masses. Tumour size and a history of ipsilateral partial nephrectomy were significantly associated with trifecta failure.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}